Cognitive Bias Modification Training Targeting Fatigue in Patients With Kidney Disease: Usability Study (Preprint)

Abstract

BACKGROUND Fatigue is an important symptom for many patients, including kidney patients. Cognitive Bias Modification (CBM) training is a promising technique to counter fatigue symptoms. OBJECTIVE The current study aimed to evaluate a CBM training among kidney patients and health care professionals. Using an iterative design process, evaluating expectations and experiences with the training, acceptability and applicability in the clinical setting were assessed. METHODS This study is a longitudinal, qualitative, and multiple stakeholder-perspective usability study interviewing end-users and health care professionals during the prototyping phase and after end of training. Semi-structured interviews were conducted with 29 patients and 16 health care professionals. The interviews were transcribed and analysed thematically. RESULTS Generally, participants were positive about the training and its applicability. The biggest negatives were doubts about effectiveness and annoyance about the repetitive character of CBM. Barriers for applicability were patients’ varying computer skills, the subjectivity of fatigue, and integration with regular treatment, (e.g., role of health care professionals). Possible solutions were assigning representatives among nurses, offering the training on an app, and providing assistance via a helpdesk. The iterative design process, including the repeated waves of testing user expectations and experiences, yielded complementary data. CONCLUSIONS The current study provided one of the first user evaluations of a CBM training, both among patients and care providers. Acceptability and applicability appear positive although barriers were identified. The proposed solutions need further testing, preferably following the same frameworks, as the iteration in the current study contributed positively to the quality of the training.

A Protocol for a feasibility study of Cognitive Bias Modification training (IVY 2.0) countering fatigue in people with breast cancer

“…Both of these studies evaluated the application with multiple stakeholders (patients and health care professionals) and revealed positive results. Although in this usability study with people suffering from breast-cancer, preliminary data analyses only revealed a trend in altering self-identity bias (33), a pilot study with people suffering from chronic kidney disease revealed strong CBM effects on cognitive bias, and promising results on symptoms and related behaviour (34).…”

“…This is also sent on Monday morning with a reminder on Wednesday morning. These procedures are inspired by a previous study with people suffering from chronic kidney disease (34).…”

“…Next, following the iterative human-centred design framework (32), our research team has investigated this novel eHealth application by researching usability. This has been done with people suffering from breast cancer (33) and from chronic kidney disease (34). Both of these studies evaluated the application with multiple stakeholders (patients and health care professionals) and revealed positive results.…”